TW200816952A - A system and method for hypertension management - Google Patents
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- TW200816952A TW200816952A TW096102196A TW96102196A TW200816952A TW 200816952 A TW200816952 A TW 200816952A TW 096102196 A TW096102196 A TW 096102196A TW 96102196 A TW96102196 A TW 96102196A TW 200816952 A TW200816952 A TW 200816952A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/022—Measuring pressure in heart or blood vessels by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H15/00—ICT specially adapted for medical reports, e.g. generation or transmission thereof
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
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- General Health & Medical Sciences (AREA)
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- Heart & Thoracic Surgery (AREA)
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Abstract
Description
200816952 九、發明說明： 【發明所屬之技術領域】 本發明係有關高血壓管理之系統鱼方法。 【先前技術】 〃 高血壓是大部分工業化國家中嚴重疾病的主要原 因，且其在發展中與貧窮國家正明顯的成長。鑑於高企 壓的治療，提供可靠的個人之血壓量測結果因而相當重 要:在傳統的患者照護流程中，患者、醫師、及藥師是 不同的、分離的個體。患者的資料或醫學記錄沒有在這 些個體中流通或共享。更重要的，在家中及在照護站 (point of care)，對患者採用血液量測的方法與程序沒有 標準化。因此，對於高血壓的診斷、治療、或藥物調整 之資訊可能不正確。對醫師或藥師而言，沒有動機來使 用對於診斷、治療、或提供足夠諮詢與教育材料或服務 之標準化的指導方針。因此，對於高金壓管理的整體控 制率僅為 21% _ 27% (參見例如 Judy Possidente Kaufman， etc·，The role of Home Blood Pressure Monitoring in200816952 IX. Description of the invention: [Technical field to which the invention pertains] The present invention relates to a system fish method for managing hypertension. [Prior Art] 高血压 High blood pressure is the main cause of serious diseases in most industrialized countries, and it is growing significantly in developing and poor countries. Given the high pressure of treatment, providing reliable personal blood pressure measurements is therefore important: in traditional patient care processes, patients, physicians, and pharmacists are distinct, separate individuals. Patient data or medical records are not circulating or shared among these individuals. More importantly, there is no standardization of methods and procedures for blood measurement in patients at home and at the point of care. Therefore, information on the diagnosis, treatment, or medication adjustment of hypertension may not be correct. There is no incentive for physicians or pharmacists to use standardized guidelines for diagnosing, treating, or providing adequate counseling and educational materials or services. Therefore, the overall control rate for high gold pressure management is only 21% _ 27% (see for example Judy Possidente Kaufman, etc., The role of Home Blood Pressure Monitoring in
Hypertension Control”，Journal of Clinical Hypertension 3(3): 171-173，2001)。因此，目前的高血壓管理系統並 不成功。 鑑於有關局金壓的治療之保險給付 (reimbursement)，目前提出開始對醫師按效果付費方案 (P4P)。同樣地，目前也計劃鑑於對藥師補償以確保服藥 遵從性之藥物治療管理(MTM)方案。在這些方案中，需 要特定文件作為證據來證明醫師與藥師已提供必需的 服務、追蹤(follow-up)及追蹤高血壓治療結果。 【發明内容】 200816952 因此，本發明之—目 高血璧管理的系統2=已:的缺點，特別是 制率。再者，根據本發明之法其可達成高整體控 療可倚賴之可靠的血^ Ί及方料提供個人的治 一種高血壓管理的方法與▲。發明之另一目的係提供 地遷守品質標準方錄可使w師或藥師容易 根據本發明，這些與 或MTM方案）的需求。 圍獨立項㈣統及方^&目的係被根射請專利範 包含至少— 用於高血壓管理。該系統 至少-照壓量測裝置。該系統更包含 站血壓量測裝置，以於一昭2二Μ、、先包3 ^蒦 χ, , ^ ^ 恥濩站供個人血壓量測。血型 盆=之照護站指的的診所、藥局、或任何 1、集中健康照護機構。根據本發明，該系統設 有貝料通訊裝備，供從該家用血壓量測裝置傳送資料至 一中央纟祠站資料庫（一照護人員（醫師或藥師）可對該中 央網站資料庫進行存取），或供傳送資料至該照護站量測 系統。該系統可結合於該個人的家中所完成的血壓量測 及於一照護站由醫師或藥師所完成的量測。雖然已知家 中量測可為正確的jk壓量測之最佳替代（參見例如Hypertension Control", Journal of Clinical Hypertension 3(3): 171-173, 2001). Therefore, the current hypertension management system is not successful. In view of the reimbursement of the treatment of the relevant financial pressure, it is currently proposed to start Physician pay-for-effects program (P4P). Similarly, there is also a plan to consider a drug treatment management (MTM) program that compensates pharmacists to ensure medication compliance. In these programs, specific documents are needed as evidence to prove that physicians and pharmacists have provided Essential services, follow-up, and tracking of hypertension treatment results. [Summary of the Invention] 200816952 Therefore, the system 2 of the present invention has the disadvantages, especially the rate. According to the method of the present invention, it is possible to achieve a reliable blood test and a prescription for relying on a high overall control therapy, and to provide a personal treatment method for hypertension management. ▲ Another object of the invention is to provide a standard for the quality of the product to be relocated. It is possible for the w or pharmacist to easily follow the requirements of the present invention, these or the MTM program. The independent project (4) and the party ^& At least - for hypertension management. The system at least - illuminating the measuring device. The system also includes a station blood pressure measuring device, for the first two, two, first, 3 ^ 蒦χ, ^ ^ shame station For personal blood pressure measurement. Blood type basin = the care station refers to the clinic, pharmacy, or any 1, centralized health care institution. According to the invention, the system is provided with shell material communication equipment for the home blood pressure measuring device Transmitting data to a central station database (a caregiver (physician or pharmacist) can access the central website database) or for transmitting data to the care station measurement system. The system can be integrated with the individual The blood pressure measurements performed at home are measured by a physician or pharmacist at a care station. Although home measurements are known to be the best alternative to correct jk pressure measurements (see for example
Laurie Barclay, uHome measurement best for accurate BP monitoring，，，BML2002; 325:254-257 or Judy PossidenteLaurie Barclay, uHome measurement best for accurate BP monitoring,,,BML2002; 325:254-257 or Judy Possidente
Kaufman et al” “The role of home blood pressure monitoring in hypertension control”，J Clin Hypertens 3(3): 171-173, 2001)，一般而言，醫師或藥師應自行額 6 200816952 血壓量測以供驗證用。根據轉明之純，一患 ::ΐ:1ί數個家，量測:透過該資料通訊裝備藉 雇)^的貝料上傳至一資料庫（特別是網站資料 這些資/料上傳至一照護站量測系統，可使照 樂師對這些量㈣料進行存取。對於不 白讀用電腦的患者或個人㈣，直 上傳特別會是較佳的選擇。 U將貝科 ，據本發明之較佳具體實_，該家g壓量測裝 ί=ί據特定預定的量測準則來決定血壓值。此根 ^床考里之篁測準則為已知。實現此 未審查中請案PCT/EP細5助3G，其内容係 :用考。根據本發明之較佳具體實施例，該 ^用Μι視裝置係設有用以輸人—量測計晝表之一 二面二^測,晝表可根據量測指導方針作成。特別 ’二據另-較佳具體實施例’除了根據量測指導方針 丨Ξ存料晝表外’對患者個辟備且根據照護人 貝的_之計晝表可被輸人至該裝置。特別地，該介面 可由該，料通訊裝備形成。此—介面考慮到對於各患者 二製=量測ΐ畫表之簡單規定，例如根據患者的 :¾½。照護人員（例如醫師）可集中地定義此一量測 不需要由照護人員或患者手動地將資料輸入 根據本發明進—步的具體實關，該家肖金壓量測 ，置可操作㈣個操作模式：於第〆自動量測 篁測係根據該量測計晝表而自祕完成。於第 測模式中’量測係僅在該使用者手動互動(m= mteractlon)之後而完成。特別地，該量測計晝表亦可定 200816952 義是否該裝置於一特定預定的時間週期中可操做於自 動或手動量測模式。特別地，根據患者的個人喜好，夜 間（night)或工作時間（working time)的量測可為自動，而 晚間（evening)或晨間（morning)的量測可為手動地開始。 根據本發明進一步的較佳具體實施例及根據本發 明之另一態樣，該家用企壓量測裝置係設有一計算裝 備’其係適於決定白袍南血壓（white coat hypertension) 或潛伏高血壓（masked hypertension)之其中至少一者。已 發現（爹見例如 P.Verdecchia，“Reference values for _ ambulatory blood pressure and self-measured blood pressure based on prospective outcome data”： blood pressure monitoring 2001，6:323-327 或 J.M.Mallion， “Detection of masked hypertension by home blood ， pressure measurements: is the number of measurements an important issue?” Blood pressure monitoring 2004, 9:301 -305)臨床血壓量測為正常之患者可能會患有高血 壓。其中三種非屬醫師的診所可測得之高血壓的這些顯 ^ 型已被描述，即晨間高血壓（morning hypertension)、夜 間高jk壓（nocturnal hypertension)、及曰間壓力高血壓 (daytime stress hypertension)。根據本發明之此態樣，提 供一自動血壓量測裝置，可由該患者使用以偵測這三種 類型的高血壓，因而有助於增加抗高血壓策略的有效 性。透過完整24小時的企壓控制，藉由家用jk壓監視 的結合之這三種類型的高血壓之偵測及參考照護站量 測，可達成更有效率地防止心血管疾病事件發生。且能 排除潛伏高血壓及白袍高企壓之影響。 根據本發明進一步的具體實施例，該系統可操作於 8 200816952 複數個不同的量測模式，例如基本/診斷模式、治療模 式、及追蹤模式。根據本發明另一較佳具體實施例，該 操作模式可透過一資料介面來選擇，特別是透過由照護 人員所做出的連線(online)或遠端互動。 再者，根據個別患者的需求，該家用血壓裝置可操 作於一般（稱為家用WatchBP)模式及於一延伸（稱為 ABPM簡化)模式。於該家用WatchBP模式，晨間與夜 間量測係手動地觸發。除了這些量測，於該ABPM簡化 模式’工作地點與夜間量測係自動地促發於一特定數量 的工作日，典型為一、二、或三個工作日。該裝置守設 有一切換器，以在這些量測模式之間切換。 根據本發明進一步的具體實施例，該照護站血壓量 測裝置係適於根據特定預先定義的量測指導方針來決 疋血【此♦曰$方針已由Pickering等人(Pickering et al·， Recommendations for blood pressure measurements in humans and experimental animals, Hypertension 2005; 45: 142-161)所揭示。適用於此量測之照護站血壓量測裝置 係揭露於該未審查申請案，具有相同的申請日，相同的 申請人，其内容係併入於此做為參考。 根據本發明之另一態樣，該系統包含至少一照護站 罝測裝置，係於一照護站供血壓量測。該照護站量測系 統係設計成以預定的品質標準來操作，特別是根據按效 果付費方案之準則或根據藥物治療管理方案之準則。此 一裝置使醫師能容易地產生實行此一方案所需的報 告。特別地，該照護站血壓量測裝置可產生醫師或藥師 對於他或她的高血壓管理及治療之服務保險給付 (reimbursed)所需的報告。雖然具有能力產生品質標準報 9 200816952 告之此系統已具有許多優點，應瞭解的是，結合上述集 成系統（具有家用及照護站量測裝置）可達成額外的優 點。 〜根據本發明之另一態樣，該系統可進一步包含至少 一豕用式遵守服藥規定監視裝置。此裝置可被設計成與 中央資料庫進行資料通訊。除了傳送血壓資料，亦可傳 达=患者的遵守服藥規定資料。特別地，若照護站系統 係没於醫師的場所或藥師的場所，則與藥師或醫師相關 的遵守服藥規定與血壓資料可於該照護站系統存取。 、於另一較佳具體實施例中，該系統係設有一中央資 料庫。此資料庫特別是一網站資料庫。於該資料庫中， 血壓資料與服藥遵從性資料可被儲存。因而，這些資料 可由複數個使用者(例如醫師、藥師、患者、護士、或其 他照護者(care giver))同時存取。醫師與藥師的知識及由 患者所完成的量测可整合在一起。有了本發明之系統， 患者、醫師、藥師、及在不同地點所做出的血壓量測及 患者遵守服藥規定資訊不再是分離的。而可整合在一整 體系統。若醫師或藥師有需要，則可下載有關疾病管理 知識的一般資訊。 根據此一資料庫，可進一步對各患者產生個人教育 報告(education report)或照護計劃(care pian)。根據患者 的情況，特別是根據二種不同顯型的高A壓之血壓值 (將說明於後文），及例如年齡、體重或類似物之參數， 可產生個別的報告與照護計劃。 鑑於以上所述，特別地，較佳根據本發明之系統係 於至少一醫師的診所及至少一藥局設有一照護站系統。 本發明之另一態樣係有關於一血壓量測農置，以於 200816952 一照護站供血壓量測。該自動血壓量測系統係設有用以 產生即將使用於品質控制方案（特別是按效果付費或藥 物治療管理方案）之報告的裝備。該血壓量測系統典型包 含一特定血壓量測裝置供臨床血壓量測。此外，此系統 設有軟體指令，其使得報告的產生可實現此按效果付費 方案的需求。特別地，以預期的資料收集流程之形式呈 現的報告(如 American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement 所提供之“Clinical performance measures, Hypertension, Tools developed by physicians for physicians”所示）可自動地以根據本發明之系統來產 生。該報告典型可包含(但不限於)所有資料紀錄、臨床 表現量測、護理計劃等。 根據本發明之另^一恶樣’提供^~種高血壓管理之方 法。根據此方法，於第一步驟，以一家用企壓量測裝置 於個人的家中決定個人的血壓值。於下一步驟，以一照 護站血壓量測裝置於一照護站決定該個人的血壓值。於 個人的家中所量測的血壓資料接著從該家用血壓量測 裝置被傳送至中央資料庫或照護站企壓量測系統。 較佳地，於個人的家中所決定之血壓資料及/威於照 護站所決定之血壓資料係根據個別的臨床建議或量測 準則來決定。 根據本發明之另一態樣，於一種高金壓管理之方法 中，於第一步驟，個人的血壓值係於一照護站決定。於 下一步驟’由軟體工具自動產生用於一品質保證方案（例 如用於按效果付費方案或藥物治療管理方案）之報告。 根據本發明之另一較佳具體實施例，除了該血壓資 11 200816952 料，於個人的家中在遵守服藥規定監視裝置中所決定 遵守服藥規定資料亦傳送至中央資料庫或照護站金壓 量測系統。 根據本發明之另一較佳具體實施例之方法，有關耒 者的資料、進一步的個人資料(例如血糖、體重、年齡^ 類似物)係傳送至中央資料庫，特別是網際網路資料庫， 其可由數個照護站系統所存取。再者，個人的個別教 報告可從此系統自動產生。 【實施方式】 一第一圖顯示根據本發明之高血壓管理系統丨的數個 元件之示意圖。第一元件包含家用血壓量測裴置1〇。根 據醫師或另一照護人員所開出的特定指導方針或醫師 計，表，個人或患者以家用血壓量測裝置1〇來進行血 壓i測。此外，用於治療計劃的遵從性資料係在患者的 家中以服藥遵從性紀錄裝置來記錄（參見第三圖）。 第一妝濩站量測系統2〇係位於醫師的診所。照護 站里測糸統20包含供數個目的使用的指導方針式軟體 (guideline based software) 〇該軟體亦可於一網站祠月艮器 (web server)，供醫師透過網際網路來連線使用（參見第 三圖）。該軟體係使用以取得在照護站根據特定指導方針 之血壓資料。再者，該軟體係使用以上傳已由該個人以 家用血壓量測裝置10在個人的家中所量測之資料。再 者，該軟體包含有關評估（assessment)、處方 (prescription)、治療計劃、或生活方式改變計劃之資訊。 最後，使用於該系統的軟體能夠因應按效果付費方案而 產生報告與文件。 第二照護站量測系統20係使用於藥局。該系統包 12 200816952 式軟體’係由一照護管理者或藥師使用，以 二佰=1務。？軟體可僅在藥師的電腦使用或可在網 枯、5供藥師連線使用。其中一任務是識別是否 患者處於風險中。該軟體之另—任務是提供 再者’錄縣適於提供報告以符合 合適文件之需求。最後，該軟體亦使用以 :地取尸堅η置10上傳資料，該資料已被患者個 :。有了照護站盔壓量測裝置21，照護站血壓量 測可f醫師的診所或藥局進行。 至里 圖顯示根據本發明於醫師的診所實行之方法 程圖。於程序開始後的第一步驟，識別一患 以昭商師的沴所，患者概況(PatientPr〇file)被建立。 永血壓里測裝置21，量測出該個人的jk壓。若 無風險，則停止根據本發明之方法。若該患者 ς = Μ有鬲血壓之風險中，則囑咐該患者以家用血壓量 二Ϊ置後文中稱為SureBP)來收集家用血壓資料。 rua >, ^昼測SureBPl〇係根據預先定義的量測準則來 i⑹別地，家用血壓量測裝置10被設計成可自動 者做出適當次數的量測。 旦第二次就診，該患者或個人將在家中以家用血壓 八、〗衣置1 〇里測的血壓資料上傳。此亦可藉由透過一 連接家用血壓量測裝置10至照護站量測系統20而 广成。該資料的上傳亦可由連線(例如藉由上傳該資料至 、條網路資料庫)來完成。 、 於下一步驟，做出對患者的評估及開立合適的治療 。對於開立該治療計劃，係使用指導方針式軟體。 /、型地’該軟體包含指導方針，例如WHO/ESH/Nffi所 13 200816952 建議者。根^該評估與該治療計劃，開出一處方而該個 人則求助於樂局。於該藥局，根據在藥局執行的指導方 針式軟體，做出該個人的諮詢與教育。再者，在藥局的 照護站糸統20產生樂師做出補償所需之mtm文件。 供從豕用血壓量測裝置上傳資料至照護站量測系 統之通訊介面可為例如USB連接。亦可使用任何其他類 型的連接。 藉由傳送資料至網際網路式資料庫，趨勢、遵守服 藥規定、或其他資訊可呈現予醫師、藥師、或其他照 遵守服樂規定可藉由使用被設計的藥物計晝表裝 置來達成。服用藥物的提醒可於螢幕上顯示。遵守的^ 認可4皮輸入至該裝置。該藥物計晝表可為同步連線。 第二圖顯示根據本發明之系統的概要圖。圖中顯示 出不同元件之間的相互通訊。於患者的家中，資料係^ 服藥遵從性記錄器與提醒器15及/或從家用血壓量測襄 置10透過網際網路傳送至網站資料庫40。透過網際^ t，此資料庫的内容亦可被瀏覽。血壓資料亦被儲存於 家用=壓量測裝置1〇,使得若該裝置10被帶至照護站: 則該貧料可被傳送至照護站量測系統20。資料可透過網 ，網路從照護站量測系統20上傳至中央資料庫4〇，使 付^於所有關聯的個體皆可存取該資料。軟體於網 服器35係為可用的。 ^照護站系統20係各設於醫師的診所與藥局。於這 ，位置收集的資料(特別是由照護站血壓量測裝置21所 的資料）或處方或諮詢資料，可透過網際網路上傳至 貧料庫40。再者，透過網際網路，可從藥局或醫師的診 14 200816952 所存取包含於資料廑4〇夕：欠 關的量測資料與知識資訊。。Μ彳地’亦可存取相 第四圖詳細顯示不同使用Kaufman et al” “The role of home blood pressure monitoring in hypertension control”, J Clin Hypertens 3(3): 171-173, 2001), in general, the physician or pharmacist should self-test 6 200816952 blood pressure measurement for verification According to the pureness of the turn, one suffering:: ΐ: 1 数 several homes, measurement: through the data communication equipment borrowed) ^ shell material uploaded to a database (especially the website information, these materials / materials uploaded to a The care station measurement system allows the music musician to access these quantities (four). For patients or individuals who do not read the computer (4), direct upload is a better choice. U will be Beko, according to the invention Preferably, the g pressure measurement device ί=ί determines the blood pressure value according to a specific predetermined measurement criterion. The detection criterion of the root bed test is known. Implementing this unreviewed request PCT /EP细5助3G, the content of which is: test. According to a preferred embodiment of the present invention, the device is provided with a device for measuring one of the two sides of the meter. The meter can be made according to the measurement guidelines. In particular, the following two According to the measurement guidelines, the stocks are stored on the outside of the table and can be input to the device according to the plan of the caregiver. In particular, the interface can be formed by the material communication equipment. This interface takes into account the simple rules for each patient's two systems, such as the patient's: 3⁄41⁄2. The caregiver (such as a physician) can centrally define this measurement without the need for manual care by the caregiver or patient. The data is input into the specific implementation according to the present invention. The home is measured by the gold pressure measurement, and the operation mode is set. (four) operation modes: the third measurement automatic measurement system is based on the measurement and measurement table. In the first test mode, the measurement system is completed only after the user manually interacts (m=mteractlon). In particular, the measurement meter can also determine whether the device is at a specific predetermined time. The cycle can be operated in an automatic or manual measurement mode. In particular, depending on the patient's personal preference, the measurement of night or working time can be automatic, and evening or morning (morning) Measurement can be In accordance with a further preferred embodiment of the present invention and in accordance with another aspect of the present invention, the home pressure measuring device is provided with a computing device that is adapted to determine white blood pressure of the white coat. Or at least one of the masked hypertension. (See, for example, P. Verdecchia, "Reference values for _ ambulatory blood pressure and self-measured blood pressure based on prospective outcome data": blood pressure monitoring 2001 , 6:323-327 or JMMallion, "Detection of masked hypertension by home blood , pressure measurements: is the number of measurements an important issue?" Blood pressure monitoring 2004, 9:301 -305) Clinical blood pressure measurement is normal The patient may have high blood pressure. These types of hypertension, which can be measured by three non-physician clinics, have been described, namely morning hypertension, nocturnal hypertension, and daytime stress. Hypertension). According to this aspect of the invention, an automatic blood pressure measuring device is provided which can be used by the patient to detect these three types of hypertension, thereby contributing to an increase in the effectiveness of the antihypertensive strategy. Through the full 24-hour pressure control, the combination of these three types of hypertension detection and reference care station measurement with home jk pressure monitoring can achieve more effective prevention of cardiovascular disease events. It can also rule out the effects of latent high blood pressure and high pressure on white robes. In accordance with a further embodiment of the present invention, the system is operable at 8 200816952 in a plurality of different measurement modes, such as basic/diagnostic mode, therapy mode, and tracking mode. In accordance with another preferred embodiment of the present invention, the mode of operation can be selected via a data interface, particularly through an online or remote interaction made by a caregiver. Furthermore, the home blood pressure device can operate in a general (referred to as Home WatchBP) mode and in an extended (referred to as ABPM simplification) mode depending on the needs of individual patients. In the home WatchBP mode, the morning and night measurements are manually triggered. In addition to these measurements, the ABPM Simplified Mode's work location and nighttime measurement system automatically triggers a specific number of workdays, typically one, two, or three business days. The device is gated with a switch to switch between these measurement modes. In accordance with a further embodiment of the present invention, the care station blood pressure measuring device is adapted to determine blood based on a particular predefined measurement guideline. [This ♦ $ policy has been adopted by Pickering et al. (Pickering et al., Recommendations) For blood pressure measurements in humans and experimental animals, Hypertension 2005; 45: 142-161). The blood pressure measuring device of the care station suitable for this measurement is disclosed in the unexamined application, having the same filing date, the same applicant, the contents of which are hereby incorporated by reference. According to another aspect of the invention, the system includes at least one care station monitoring device for blood pressure measurement at a care station. The care station measurement system is designed to operate with predetermined quality standards, particularly in accordance with guidelines for pay-as-you-go schemes or according to guidelines for medication management protocols. This device allows the physician to easily generate the reports needed to implement this protocol. In particular, the care station blood pressure measuring device can generate a report required by a physician or pharmacist for reimbursed his or her hypertension management and treatment services. Although the system has many advantages to the ability to produce quality standards, it is understood that the integration of the above-described integrated system (with home and care station measuring devices) can achieve additional advantages. - According to another aspect of the invention, the system can further comprise at least one tamper-compliant medication prescription monitoring device. This device can be designed to communicate with the central repository. In addition to transmitting blood pressure data, it is also possible to pass the patient's compliance with medication regulations. In particular, if the care station system is not at the physician's site or at the pharmacist's location, the medication and blood pressure data associated with the pharmacist or physician may be accessed at the care station system. In another preferred embodiment, the system is provided with a central repository. This database is especially a website database. In this database, blood pressure data and medication compliance data can be stored. Thus, such information can be accessed simultaneously by a plurality of users (e.g., physicians, pharmacists, patients, nurses, or other care givers). The knowledge of the physician and the pharmacist and the measurements performed by the patient can be integrated. With the system of the present invention, patients, physicians, pharmacists, and blood pressure measurements made at different locations and patient compliance medication guidelines are no longer separate. It can be integrated into an entire system. General information about disease management knowledge can be downloaded if needed by a physician or pharmacist. According to this database, an individual education report or care pian can be further generated for each patient. Individual reports and care plans can be generated depending on the patient's condition, particularly based on the high A pressure blood pressure values of two different phenotypes (described below), and parameters such as age, weight or the like. In view of the above, in particular, it is preferred that the system according to the present invention is provided with a care station system for at least one physician's clinic and at least one pharmacy. Another aspect of the present invention relates to a blood pressure measurement for use in a blood pressure measurement at a care station in 200816952. The automatic blood pressure measurement system is provided with equipment for generating reports to be used in a quality control scheme, particularly a pay-per-action or medication treatment management scheme. The blood pressure measurement system typically includes a specific blood pressure measurement device for clinical blood pressure measurement. In addition, the system is equipped with software instructions that enable the generation of reports to meet the needs of this pay-per-action solution. In particular, reports presented in the form of an expected data collection process (as shown in "Clinical performance measures, Hypertension, Tools developed by physicians for physicians" by American College of Cardiology/American Heart Association/Physician Consortium for Performance Improvement) It can be produced automatically in the system according to the invention. The report typically includes, but is not limited to, all data records, clinical performance measures, care plans, and the like. According to another embodiment of the present invention, a method for managing hypertension is provided. According to this method, in the first step, the blood pressure value of the individual is determined by the home pressure measuring device in the individual's home. In the next step, the blood pressure value of the individual is determined at a care station by a care station blood pressure measuring device. The blood pressure data measured at the individual's home is then transmitted from the home blood pressure measuring device to a central database or a care station pressure measurement system. Preferably, the blood pressure data determined at the individual's home and/or the blood pressure data determined by the care station are determined based on individual clinical recommendations or measurement criteria. According to another aspect of the present invention, in a method of high gold pressure management, in the first step, the blood pressure value of the individual is determined at a care station. In the next step, a report for a quality assurance program (e.g., for a pay-per-effects program or a drug treatment management program) is automatically generated by the software tool. According to another preferred embodiment of the present invention, in addition to the blood pressure resource 11 200816952, the information required to comply with the medication prescriptions in the individual's home in compliance with the medication prescription monitoring device is also transmitted to the central database or the nursing station for gold pressure measurement. system. According to another preferred embodiment of the present invention, information about the learner, further personal data (eg, blood glucose, weight, age, and analog) is transmitted to a central repository, particularly an internet database. It can be accessed by several care station systems. Furthermore, individual individual teaching reports can be automatically generated from this system. [Embodiment] A first diagram shows a schematic diagram of several components of a hypertension management system according to the present invention. The first component contains a home blood pressure measurement device. According to the specific guidelines or physicians prescribed by the physician or another caregiver, the table, the individual or the patient performs a blood pressure measurement using the home blood pressure measuring device. In addition, compliance data for the treatment plan is recorded in the patient's home with a medication compliance record device (see Figure 3). The first makeup station measurement system 2 is located in the physician's clinic. The sputum system 20 in the care station contains guideline based software for several purposes. The software can also be used on a web server for doctors to connect via the Internet. (See the third picture). The soft system is used to obtain blood pressure data based on specific guidelines at the care station. Furthermore, the soft system is used to upload data that has been measured by the individual at home in the home with the home blood pressure measuring device 10. Furthermore, the software contains information about assessments, prescriptions, treatment plans, or lifestyle change plans. Finally, the software used in the system can generate reports and documents in response to pay-per-effect schemes. The second care station measurement system 20 is used in the pharmacy. The system package 12 200816952 software is used by a care manager or pharmacist. ? The software can be used only on the pharmacist's computer or can be used in the network and 5 pharmacists. One of the tasks is to identify if the patient is at risk. The other task of the software is to provide a further requirement for the county to provide reports to meet the appropriate documents. Finally, the software is also used to upload data to the corpse, which has been used by the patient: With the nursing station helmet pressure measuring device 21, the blood pressure measurement of the nursing station can be performed by the clinic or the pharmacy of the doctor. The figure shows a method of implementation in a physician's clinic in accordance with the present invention. In the first step after the start of the procedure, a clinician (PatientPr〇file) is created. The permanent blood pressure measuring device 21 measures the jk pressure of the individual. If there is no risk, the method according to the invention is stopped. If the patient has a risk of sputum ς = Μ , 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 嘱咐 家用 家用 家用 家用 家用 家用 家用Rua >, ^ Sure BPl is based on pre-defined measurement criteria i (6) In addition, the home blood pressure measuring device 10 is designed to automatically make the appropriate number of measurements. On the second visit, the patient or individual will upload blood pressure data at home using the blood pressure of the home. This can also be achieved by connecting the home blood pressure measuring device 10 to the care station measuring system 20. The uploading of this information can also be done by connecting (for example, by uploading the data to a network database). In the next step, make an assessment of the patient and open appropriate treatment. For the opening of this treatment plan, a guideline software is used. /, type 'The software contains guidelines, such as WHO/ESH/Nffi 13 200816952. The assessment and the treatment plan, a prescription is issued and the individual resorts to the music bureau. At the pharmacy, the individual's counseling and education is based on the instructional software that is implemented at the pharmacy. Furthermore, in the pharmacy's care station, the system 20 generates the mtm files required for the musician to make compensation. The communication interface for uploading data from the blood pressure measuring device to the care station measuring system may be, for example, a USB connection. Any other type of connection can also be used. By transmitting data to an Internet-based database, trends, compliance with medication regulations, or other information can be presented to physicians, pharmacists, or other compliance regulations by using the designed medication metering device. A reminder to take the medication can be displayed on the screen. Obey the ^ approval 4 skin input to the device. The drug schedule can be synchronized. The second figure shows an overview of the system according to the invention. The figure shows the mutual communication between the different components. In the patient's home, the data is passed to the website database 40 via the medication compliance recorder and reminder 15 and/or from the home blood pressure measurement device 10 via the Internet. The contents of this database can also be viewed through the Internet. The blood pressure data is also stored in the home = pressure measuring device 1 such that if the device 10 is brought to the care station: the lean material can be transferred to the care station measuring system 20. The data can be uploaded from the care station measurement system 20 to the central repository via the network, so that all associated individuals can access the data. The software is available in the web server 35. ^ The care station system 20 is located at the physician's clinic and pharmacy. Here, the information collected at the location (especially the data from the care station blood pressure measuring device 21) or the prescription or consultation data can be uploaded to the poor storage bank 40 via the Internet. Furthermore, through the Internet, the measurement data and knowledge information contained in the data can be accessed from the pharmacy or doctor's consultation 14 200816952. . The ground floor can also be accessed. The fourth picture shows the different uses in detail.
資=内ΐ及其互動。特別地，患者可以= 貝料庫，且該患者可將以家用企壓量測f U =。於醫師診所之醫師亦二照;==Capital = guilt and its interaction. In particular, the patient can = a bin, and the patient can measure f U = at home pressure. The doctor at the doctor's office also took two photos; ==
Lf麼資料上傳至資料庫4〇。此外= 籲 據才曰¥方針的治療，醫師可存取特定工罝。二j 保服藥遵從性。再者，患者可1傳; 網站貢料庫40。 、攸貝枓至 明完ί五圖顯示P4P料的具體實施例，其將利用本發 第六圖顯示家用血壓量測|置3 =用血壓量測裝置31係利用USB連接 個人電腦或膝上型電腦a亦可使用熟知本技4= 的任何其儲型之資料軌連接來代# USB連。接者膝上 由網際網路連接而連接至網站資料庫伺 =34。根據預定的量測指導方針之儲存於家用血壓 里測衣置31之量測計晝表，可包含於該裝 USB連接33來修改。特別地，照護人貝（例如醫師)可透 =師的賴之膝上型電腦35與卿連接33或藉由網 據量測指導方針’對於—患者個別地 輸^測計晝表。透過網站資料庫34、膝上型電腦％、 ^豕用血壓量測裝置31之間的連接，此量測計畫表可 $至家用血壓_裝置31。因此，不f要照護人以 Μ者個別地輸入一特定量測計畫表至裝置31。 15 200816952 △感1 了提升南血壓管理系統的結果，該系、统(亦即家用 里測裝置及/或照護站量測系統）可設有一計算配 丄以決定潛伏高血壓、夜間高血壓、白袍高灰塵。因 ^豕^壓量職置與照護站量測裝⑽結合，決定白 =、仗間、或潛伏高血壓所需的資訊可於單—系統中使 用’使得能夠自動決定。第七a圖、第七b®、第七c 圖顯不此系統的操作流程圖。Lf data is uploaded to the database 4〇. In addition, the doctor can access specific work orders. Two j guarantee medication compliance. Furthermore, the patient can pass 1; the website tribute library 40.攸 枓 枓 明 完 完 ί 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 显示 具体 具体 具体 具体 具体 具体 具体 具体 具体 具体 具体 具体 具体The computer a can also use the data track connection of any of its storage types known as the 4= to connect to the USB connection. The receiver's lap is connected to the website database by the Internet connection. The measurement gauge stored in the home blood pressure according to the predetermined measurement guidelines may be included in the USB connection 33 to be modified. In particular, the caregiver (e.g., a physician) can pass through the teacher's laptop 35 and the connection 33 or use the network measurement guidelines to individually test the patient. Through the connection between the website database 34, the laptop %, and the blood pressure measuring device 31, the meter can be used to the home blood pressure_device 31. Therefore, it is not necessary for the caregiver to individually input a specific gauge to the device 31. 15 200816952 △ Sense 1 The result of upgrading the South Blood Pressure Management System, which can be equipped with a calculation quota to determine latent hypertension, nocturnal hypertension, White robe is high in dust. Because the combination of the pressure and the nursing station (10), the information needed to determine white =, daytime, or latent hypertension can be used in a single system to enable automatic decision. The seventh a diagram, the seventh b®, and the seventh c diagram show the operation flow chart of the system.
於第七a圖中，顯示根據本發明對於可能患有高血 昼的患者向醫師諮詢之步驟的流程圖。於第 "^次>?尤珍’ f诸巧的診所以照護站量測裝置做出血壓量測 。此量測 H量測結果咖1。此量測可以«裝置(後文中稱為 專業用伽讀”)來做出。為了決定根據已知指導方針 =後續量測之較佳的量測臂，可於兩臂皆做出量測。接 者，酉師扣定豕用血壓量測裝置（後文中稱為“家用 WatehBP”）°患者根據醫師所開出的量測計晝表在家中 量測血壓。該患者被要求在晨間與晚間量測血壓，得到 血壓值Μ一BP與E_BP。根據此晨間與晚間量測得到一 平均SBP1。典型地，根據醫師的醫囑重複量測數天， 例如七個工作天。該平均SBP1係為這些天期間所有量 測的平均。然而，根據建議的家用血壓量測指導方針， 隶韵面天的項數可被排除。於此量測週期期間，家用 WatchBP係手動地操作而尚未根據規定的量測計晝表。 於醫師的#所之弟一次追蹤就診，以照護站量測裝 置做出第二量測’得到量測結果CBP2。根據兩個昭^ 站量測CBP1與CBP2而得到一平均CBP12。於下I步 驟，該個人取得之第一自行量測血壓資料被下载至誃^ 統。知別地，於本文中，此糸統為網站資料庫伺服哭’，' 16 200816952 可從醫師的診所進行存取。 若照護站量測CBP12的平均與家中量測SBpi的平 ，超過135/85 mmHG，則判斷該血壓為異常地高且開始 藥物治療。 匕七右家中量測的血壓或照護站量測是正常的，則醫師 ^定一動態血壓監視器予該患者，以評估該患者是否可 能患有白袍或潛伏高血壓。對於此目的，透過上述之該 連接將家用血壓量測裝置設計成運作於一“ABpM簡化，， 模式。 ^ ^家用WatChBP模式，量測係在晨間與晚間做出。 這些量測係被手動地觸發。典型地，於各工作日，做出 兩個接著的量測。在第一量測之後，倒數6〇秒，自動 開始第二量測。該血壓讀數由這兩個讀數的平均產生。 做出量測的預設值係在6·00與9.00pm及6 〇〇am與 9.00am之間。該平均可被計算及/或儲存於家用量測裝 运擇性地’當該裝置被設計成在該ABPM簡化功能 8$，工作地點與夜間量測係被做出。典型地，一量測係 在一、或二個工作日期間做出。量測係在9.30am 與11.30am及2.00pm與4.30pm之間的曰間期間每15 至2〇分鐘自動地被觸發。在夜間期間，量測係在1 〇〇am 與4.00ain之間每45分鐘自動地被觸發。 特別地 ，一該裝置係被設計成根據預定的量測書表 以及預先儲存的指導方針式計畫表來操作。特別i也，^ 於做出曰間期間與夜間期間之量測的量測計書 與 晨間與晚間量測-起設計。這些量_產生晨間^结^ Μ BP、日間量測結果D BP、晚間量測結果£ 、及夜 17 200816952 結t = BP。同樣的，這些量測結果可被儲存及/ 或使用以計算於家用量測褒置。 仔及/ 的例:=:點或气In Figure 7a, a flow chart showing the steps of consulting a physician for a patient who may have high blood stasis according to the present invention is shown. In the clinic of the first "^ times>? Youzhen’s, the blood pressure measurement was performed by the nursing station measuring device. This measurement H measurement results coffee 1 . This measurement can be made by means of a device (hereinafter referred to as a professional gamma read). In order to determine a preferred measurement arm according to known guidelines = subsequent measurements, measurements can be made on both arms. In addition, the sergeant deducted the blood pressure measuring device (hereinafter referred to as "home WatehBP"). The patient measured the blood pressure at home according to the measurement meter issued by the doctor. The patient was asked to be in the morning with Blood pressure is measured at night to obtain blood pressure values ΜBP and E_BP. An average SBP1 is obtained based on this morning and evening measurements. Typically, the doctor's doctor's order is repeated for several days, for example, seven working days. The average SBP1 is For the average of all measurements during these days. However, according to the recommended guidelines for home blood pressure measurement, the number of items in the rhyme can be ruled out. During this measurement period, the household WatchBP is manually operated but not yet specified. The measurement of the meter. The follow-up visit of the physician of the doctor's #, and the second measurement by the nursing station measuring device' obtained the measurement result CBP2. According to the measurement of CBP1 and CBP2 by the two stations An average CBP12. In the next step I, The first self-measured blood pressure data obtained by the individual was downloaded to the system. In this article, this system is the server database crying, ' 16 200816952 can be accessed from the doctor's clinic. The station measured CBP12 average and the home measurement SBpi level, more than 135/85 mmHG, it is judged that the blood pressure is abnormally high and the drug treatment is started. The blood pressure or care station measurement measured in the right home is normal. The physician then assigns a dynamic blood pressure monitor to the patient to assess whether the patient may have white robes or latent hypertension. For this purpose, the home blood pressure measuring device is designed to operate in an "ABpM" through the connection described above. Simplified, mode. ^ ^ Home WatChBP mode, the measurement system is made in the morning and evening. These measurements are triggered manually. Typically, two subsequent measurements are taken on each business day. After the first measurement, the countdown is 6 seconds and the second measurement is automatically started. This blood pressure reading is produced by the average of these two readings. The preset values for the measurements are between 6·00 and 9.00 pm and between 6 〇〇 am and 9.00 am. The average can be calculated and/or stored in a household metering device. 'When the device is designed to be used in the ABPM Simplified Function 8$, the work location and nighttime measurement system are made. Typically, a measurement system is made during one or two business days. The measurement system is automatically triggered every 15 to 2 minutes during the day between 9.30 am and 11.30 am and between 2.00 pm and 4.30 pm. During the night, the measurement system is automatically triggered every 45 minutes between 1 〇〇 am and 4.00 ain. In particular, the apparatus is designed to operate in accordance with a predetermined gauge and a pre-stored guideline schedule. In particular, it is also used to measure the measurement of the daytime and nighttime measurements and the morning and evening measurements. These quantities _ produce morning ^ junction ^ Μ BP, daytime measurement results D BP, night measurement results £, and night 17 200816952 knot t = BP. Similarly, these measurements can be stored and/or used to calculate the home measurement device. Aberdeen and / example: =: point or gas
嘴；時:=㈣設計 出第」：厂二Ϊ椒就珍’在照護站以照護站量測裝置做 得到血壓值_。第二次追縱就診 m在兩個星期以後。該患者被要求以裝置31 ==1例如七個工作天。此將產生至少12 “aSpm-可罪的結果所需。#該裝置被設計成於 ABPM間化模式，，時，其被設計成僅在特定日（例如一、 二、或三天之前)作用。 平均CBP23係根據第二血壓量測cbP2與第三（第 一次追縱)血壓量測CBP3而產生。自行量測所取得的血 壓資料接著被下載至此系統，特別是至網站資料庫。 下列資料係根據家中量測期間儲存於家用量測裝 置中的資料來決定·· -平均值awakeBP係由所有的晨間、曰間、及晚間 血壓量測之平均來產生， -平均asleepBP係由所有夜間時間量測之平均來產 生， 18 200816952 -平均workBP係由所有日間量測dayBP之平均來產 生。 -晨間平均M—av係由所有晨間量測MBP之平均來 產生， ， -晚間平均E一av係由所有晚間量測E—BP之平均來 產生。 晨間晚間差Μ E 一 d i ff係由晨間平均與晚間平均之間 的差產生。 根據這些值，開始潛伏高金壓與白袍高血壓量測迴 圈（loop)A(參照第七b圖）。 於第一步驟，判斷是否患者具有白袍高血壓。若清 醒jk壓（awakeBP)低於130/80mmHG，則判斷患者患有白 袍高血壓而有低度風險。若患者沒有風險因子（例如糖尿 病、靶器官損傷、或其他風險因子），則可指定生活方式 量測，例如自行血壓監視或其他後續行動步驟。不需要 進一步的量測。 若患者具有其他風險因子，則參考治療指導方針且 開始合適的治療。 若判斷患者沒有白袍高血壓，則於下一步驟判斷是 否患者患有潛伏高血壓。於一選擇的迴圈B(參考第七c 圖），可偵測潛伏高血壓的類型。 於第一步驟，參數 Nightjreduction 係由（awakeBP -asleepBP)/(awakeBP)產生。若該參數 Night—reduction < 0·1，則判斷患者患有夜間高血壓。於第二步驟，判斷是 否晨間晚間平均ME_av超過135及是否晨間晚間差 ME_diff超過20。若兩者皆為是，則判斷患者患有晨間 高血壓。於下一步驟’驗證是否工作量測workBP之平 19 200816952 均超過晨間晚間平均ME_av。若為是，則判斷患者曰間 壓力高血壓。這三種類型的潛伏高血壓並非彼此不相 關。夜間高血壓典型地對於患者呈現最高的風險。潛伏 高血壓的類型之分類有助於照護人員個別地治療各患 者。患有夜間高金壓之患者可特別地被開出睡前服用之 藥物。 於下一步驟，該系統顯示或指示該患者患有哪一類 型的潛伏咼jk壓。此顯示典型地例如於醫師的診所在該 網際網路瀏覽器上之系統做出。 於下一步驟（參考第七b圖），分析是否血壓在夜間 期間下降(dipping)。若參數 Night一reduction 係< 0.1，則 判斷壓力沒有下降而患者係處於高風險。 若血壓下降，於下一步驟判斷對於晨間、晚間、日 間、及夜間量測M—BP、E—BP、D一BP、及NJBP是否脈 博壓力< 53mmHG。 脈博壓力PP係由心臟收縮的及心臟舒張的血壓量 測之間的所有差之平均產生(PP =所有平均（心臟收縮 BP-心臟舒張BP))。 此值係根據儲存的血壓值鑑於脈博壓力判斷（第七 b圖），由該系統所計算而作為暫存值。 若脈博壓力低於53mmHG(判斷為正常），則患者係 處於中度風險，而係求助於特定指導方針以進行治療。 特別地，其係判斷是否藥物治療是必需的，且根據該結 果，處以生活方式量測或開始藥物治療。 " 若脈博壓力超過53 mmHG，則判斷患者係處於高度 風險。開始藥物治療，以防該患者處於高度風險。又 於第一次就診期間，建立患者概況。於兩臂皆量測 20 200816952 血壓，且指定實驗室血液檢驗與家用血壓量測裝置。 於第二次就診期間，檢閱實驗室血液檢驗結果。 於第三次就診期間，開出藥物並建立照護計則。溢 物的開立及照護計劃的建立終止該診斷階段。—市 於治療階段之進一步就診期間，可調整藥物且可 立或調整照護計劃。於此就診期間，家中量測的血次 料被上傳。 貝 若需要，醫師亦可在第一次就診開立晨間、晚間、 夜間、及工作地點量測的量測計晝表。例如，對於第一 次就診時具有正常診所血壓的患者（仍抱怨在日間戋睡 眠時間期間有不舒服的症狀），可開立根據例如包含 ΑΒΡΜ簡化功能(如第七a圖所示關於醫師）的量測計查 表之量測裝置。 、ΰ旦 第八圖顯示以根據本發明之系統實施的不同步驟 之概要圖。於最初診斷階段，個人求助於醫師的診所戈 照護站，而家用血壓量測係在曰間期間與夜間期間於I 者的家及於工作地點做出。 傳統BP量測方法的缺點（例如白袍或潛伏高血壓、 錯誤報告、人為疏失、或血壓波動）係被克服。該系統不 昂貴且因此克服傳統BP量測方法的進一步的_個缺點。 若發現患者患有高血壓，則在治療階段建立根據指 導方針的特定照護計劃（藥物開立及生活方式改變^ 物係以證據式方式（evidence based manner)來調整，將顯 示於後文。於追蹤階段，係在家中監視血壓值。再者二' 於此追蹤階段期間，服藥遵從性亦以根據本發明之該系 統來監視。 μ 開始階段、治療階段、及追蹤階段共同考慮到高血 21 200816952 ，二f與改良的系統化及綜合方式。第三圖所示之藥盒 =酉=心、者 '樂。再者，登記服用記錄（如业6 history)以驗 也，寸服藥規定。該遵守資料係從家中或從藥局或醫師 的f所傳送至網站資料庫伺服器。有了藥物與血壓資料 的幫f ’照護人員可立即地監視藥物效果。此系統化工 具可幫助醫師決定最適合的藥物。 杏第九圖顯示根據本發明之患者照護流程的替代具 體貝知例。第九圖概述使用根據本發明之系統的流程圖 之另可處性。除了家用jk壓量測，亦可指定實驗室試 驗。再者’在診斷後，特定照護計劃與處方可藉由電子 f方連線發出。同樣的，可指定生活方式改變。再者， 可，據本發明之系統所做出的量測及診斷，設計藥物或 ，樂劑營養品（nutra_ceuticals)。利用電子通訊與遠距離 鲁術(^6161116(1沁比6)，醫師可與在家的患者通訊，以考慮 到^行，康管理的·進一步實現。再者，家用血壓量測^ 遵守服樂規定資料可利用資料庫來交換，而可透過醫師 的診所進行存取。 ^ 藉由照護者激勵患者或提醒患者採取後續行動，該 系統可進一步提高效能。同樣的，藉由存取該系統所收 集並儲存的資料，包含營養學者、心理學家、治療學家、 或藥師之社區健康照護組織(例如學習中心）可為該系統 之一部分。 根據本發明之此系統包含照護站血壓量測裝置、家 用企壓量測裝置、及用於量測之結合管理及這些裝置所 提供的量測結果之系統。此系統係根據網際網路瀏覽 器’其可顯示資料並輸入資料於網站資料庫，例如標準 Microsoft SQL server 2000 〇 22 200816952 於第十a圖中，顯示用於輸入特定患者之患者概況 的劇覽器頁。除了患者的個人資料，可提供特定治療指 導方針（例如 JNC7(JNC7: the Seventh Report of the JointMouth; Time: = (4) Design The first: "The second plant of the factory is set aside." At the care station, the blood pressure value is obtained by the monitoring station. The second time to see the doctor m after two weeks. The patient is required to have device 31 = =1 for seven working days. This will produce at least 12 "aSpm - guilty results required. # The device is designed to be in the ABPM mode, when it is designed to act only on certain days (eg one, two, or three days ago) The average CBP23 is generated based on the second blood pressure measurement cbP2 and the third (first time tracking) blood pressure measurement CBP3. The blood pressure data obtained by self-measurement is then downloaded to the system, especially to the website database. The data is determined based on the data stored in the household measurement device during the measurement in the home. · The mean awakeBP is generated by the average of all morning, daytime, and evening blood pressure measurements. - The average asleepBP is owned by The average of nighttime measurements is generated, 18 200816952 - The average workBP is generated by the average of all daytime measurements of dayBP. - The average morning M-av is generated by the average of all morning measurements of MBP, - Evening average E-av is generated by the average of all nighttime E-BP measurements. Morningtime E-difference E-di ff is generated by the difference between the morning average and the evening average. Based on these values, the latent high gold pressure is started. White robe high blood Pressure measurement loop (refer to Figure 7b). In the first step, determine whether the patient has white robe hypertension. If the awake BP pressure (awakeBP) is lower than 130/80mmHG, the patient is judged to have white Robes with high blood pressure and low risk. If the patient does not have risk factors (such as diabetes, target organ damage, or other risk factors), you can specify lifestyle measurements, such as self-monitoring or other follow-up steps. No further steps are required. If the patient has other risk factors, refer to the treatment guidelines and start appropriate treatment. If the patient is judged to have no white-blood hypertension, determine whether the patient has latent hypertension in the next step. B (refer to Figure 7c), which can detect the type of latent hypertension. In the first step, the parameter Nightjreduction is generated by (awakeBP -asleepBP)/(awakeBP). If the parameter Night-reduction < 0·1, Then, the patient is judged to have nocturnal hypertension. In the second step, it is judged whether the average morning ME_av exceeds 135 and the morning and evening difference ME_diff exceeds 20. If both are yes, then Judging that the patient has morning hypertension. In the next step, 'Verify whether the work measurement workBP level 19 200816952 exceeds the morning average ME_av. If yes, judge the patient's daytime pressure hypertension. These three types Latent hypertension is not irrelevant to each other. Nocturnal hypertension typically presents the highest risk to patients. The classification of types of latent hypertension helps caregivers treat individual patients individually. Patients with nighttime high gold pressure can be specifically Take out the medicine taken before going to bed. In the next step, the system displays or indicates which type of latent 咼 jk pressure the patient has. This display is typically made, for example, at the physician's clinic on the system on the internet browser. In the next step (refer to Figure 7b), analyze whether blood pressure drops during nighttime (dipping). If the parameter Night-reduction is < 0.1, then the pressure is not lowered and the patient is at high risk. If the blood pressure drops, the next step is to determine whether M-BP, E-BP, D-BP, and NJBP are pulse pressure < 53 mmHG for morning, evening, day, and night. Pulse pressure PP is the average of all differences between cardiac contraction and diastolic blood pressure measurements (PP = all mean (systolic BP-cardiac diastolic BP)). This value is determined by the system as a temporary value based on the stored blood pressure value in view of the pulse pressure (seventh b). If the pulse pressure is below 53 mmHG (which is judged to be normal), the patient is at a moderate risk and is seeking specific guidelines for treatment. Specifically, it is judged whether or not medical treatment is necessary, and according to the result, lifestyle measurement or medical treatment is started. " If the pulse pressure exceeds 53 mmHG, the patient is judged to be at high risk. Start medication to prevent the patient from being at high risk. A patient profile was also established during the first visit. The blood pressure was measured on both arms, and the laboratory blood test and home blood pressure measurement device were designated. During the second visit, review the laboratory blood test results. During the third visit, the drug was prescribed and care plans were established. The opening of the spill and the establishment of the care plan terminate the diagnostic phase. - During the further visits to the treatment phase, the drug can be adjusted and the care plan can be adjusted or adjusted. During this visit, the blood samples measured at home were uploaded. If necessary, the doctor can also open a measurement schedule for the morning, evening, night, and workplace measurements at the first visit. For example, for patients with normal clinic blood pressure at the first visit (still complaining of uncomfortable symptoms during daytime sleeptime), it can be opened according to, for example, a simplified function (including the physician shown in Figure 7a) The measuring device of the metering table. Finally, the eighth figure shows a schematic diagram of the different steps implemented in accordance with the system of the present invention. At the initial diagnosis stage, the individual turned to the physician's clinic, and the home blood pressure measurement system was made during the daytime and during the nighttime at the home of the I and at the workplace. Disadvantages of traditional BP methods (such as white robes or latent hypertension, false reports, human error, or blood pressure fluctuations) are overcome. This system is inexpensive and thus overcomes a further disadvantage of conventional BP measurement methods. If the patient is found to have high blood pressure, a specific care plan based on guidelines (drug opening and lifestyle changes) will be established during the treatment phase. The system will be adjusted in an evidence based manner. In the tracking phase, the blood pressure value is monitored at home. In addition, during this tracking phase, the medication compliance is also monitored by the system according to the present invention. μ The initial phase, the treatment phase, and the tracking phase together consider the high blood 21 200816952, two f and improved systematization and comprehensive way. The kit shown in the third figure = 酉 = heart, person 'le. In addition, the registration record (such as 6 history) to check, also take the drug regulations. The compliance data is transmitted from the home or from the pharmacy or physician's f to the website database server. With the medication and blood pressure data, the caregiver can immediately monitor the drug effect. This systematic tool can help the physician decide The most suitable drug. The ninth figure of apricot shows an alternative specific example of the patient care process according to the invention. The ninth figure summarizes the flow chart using the system according to the invention. In addition to home jk pressure measurement, laboratory tests can also be specified. In addition, after diagnosis, specific care plans and prescriptions can be issued by electronic f-connection. Similarly, lifestyle changes can be specified. Furthermore, according to the measurement and diagnosis made by the system of the present invention, the drug or the nutrient (nutra_ceuticals) is designed. The electronic communication and the remote intelligence are used (^6161116 (1沁6), the physician It can be communicated with patients at home to take into account the implementation of the health management. In addition, the home blood pressure measurement ^ compliance with the music regulations can be exchanged using the database, and can be accessed through the doctor's clinic. ^ The system can further improve performance by motivating the patient or alerting the patient to follow up. Similarly, by accessing the data collected and stored by the system, including nutritionists, psychologists, therapists, or The pharmacist's community health care organization (eg, a learning center) may be part of the system. The system according to the present invention includes a care station blood pressure measuring device, a home pressure measuring device, and A system for measuring the combined management and measurement results provided by these devices. This system is based on the Internet browser's ability to display data and enter data into a website database, such as the standard Microsoft SQL server 2000 〇22 200816952 In the tenth a picture, a browser page for inputting a patient profile of a specific patient is displayed. In addition to the patient's profile, specific treatment guidelines can be provided (for example, JNC7: the Seventh Report of the Joint)
National Committee on Preventi〇n，Detection, Evaluation， and Treatment of High Blood Pressure)、風險因子（例如抽 煙、肥胖、或家族病史）、相關的臨床情況或體重。此外， 開立予該患者之家用企壓量測裝置係定義為“工具 (tool)，，。 ’、 此工具的操作係建立於家用BP管理頁，顯示於第 十b圖。有了顯示於第十b圖之建立工具，根據第七& 圖所示的步驟，在設計第一追蹤就診（參見第七a圖） 之後實施量測計晝表。有了該建立工具，具有清楚的序 號之該裝置之特定模型係被定義。動態血壓量測週期係 被定義於一特定數量的工作日。特定量測計晝表係被定 義於晨間與中下（在工作地點）及於夜間期間。 藉由儲存該資料，如第十b圖所示，資料係被儲存 於資料庫且可透過第六圖所示之網際網路與USB連接 被傳送至家用血壓量測裝置。 第十c圖顯示診斷階段期間患者資料的晝面。診 階段係被定義為最初、第一次、及第二次追蹤就診的階 段，如第七a圖所示。於一相同的網頁中，顯示第一^ 蹤就診之前照護站/診所血壓量測裝置所做的量測結= 與家用血壓量測裝置所做的量測，及在第一與第二 望測之間以ABPM簡化裝置所做的量測。αβρμ簡化壯 置與用於平均家用血壓量測之裝置係完全相同的= 置。晨間/晚間功能為嵌入該裝置之功能。若該裴置被= 計成於ABP1V[簡化模式，則可進行指定的晨間及晚間^ 23 200816952 測。該裝置之ABPM簡化功能可由醫師利用軟體切換哭 來啟動或不啟動。根據醫師的選擇，可在任何診斷、、^ 療、或追蹤階段期間啟動ABPM簡化功能。 & &根據是否醫師認為晨間或晚間量测合適，可啟動此 此外，可儲存實驗室試驗、特定照護計劃（亦參見 十一圖）、及規定的特定藥物。在診斷階段結束之 :治療。藉由以瀏覽器式介面來選擇階段灸; 家用血壓量測裝置改變成治療模式。第;= 顯不>口療模式期間特定患者的紀錄之畫面。 圖 料係於螢幕上以圖形來顯示。此外，係浐干 物與血壓監視，提供用於 荦立的藥 類型的藥物係被開立於從例如；的工具。第一 年5月20日。於5月川口 i年月5日至2006 個別顏色在圖形的水平軸顯m立的，。藉由以 於血壓量測的量測結果。、、不同類型的藥物係關聯 此外，於治療階段期間， 細情形可藉由超鏈結來存取』二關里測結果。詳 -旦完成治療，# ，更坪細的量測結果。 模式。第十e圖顯示=、έ /A “堃量測裝置被改變成追蹤 患者之網頁瀏“ c顯示於之前圖式的特定 醒(例如提醒預約看^^旦面。可儲存醫師用之數個提 做特定試驗，例如上y徒醒專業管理者(case manager) 物相關問題）。這些接H 壓貧料或提醒患者例如藥 闕各人員的信箱：於二浐=至個別人員於此系統中有 果之遵從性資訊。 吴武，係指示有關血壓量測結 24 200816952 =s移畊階段、治療階段、追蹤階段之步驟的特定 實施你f总二七-1- 士 · 4月1曰第 一次就診 -建立患者概況 ，用專業用WatchBP，以最初就 診模式，於兩臂量測0ffice-BP 一指定實驗室試驗 一指定家用WatchBP予患者 一 ^醫師認為有需要，則以“ABPM 簡化”功能量測一至三天，亦要求 患者在指定日期做出夜間與工作 地點量測 4月15曰第 —次就診 一 1 吏用專業用WatchBP，以追蹤就 診模式，於具有較高BP之臂， 量測 Office-BP -上傳家用WatchBP及ABPM簡 化資料 一檢閱實驗室試驗結果 一根據指導方針做出診斷 -開立藥物 一建立護理計劃 二予患者 5月10曰第 三次就診， 例如透過網 際網路諮詢 -上傳家中的家用WatchBp及 ABPM簡化(若有需要)資料，而 醫師透過WatchBP.NET檢閱 Home BP資料及服藥遵從性資訊 一醫師決定調整藥物於5月1〇日 -醫師口頭上或透過網際網路信箱 _旁知該患者藥物的改^ 25 200816952National Committee on Preventi〇n, Detection, Evaluation, and Treatment of High Blood Pressure), risk factors (e.g., smoking, obesity, or family history), related clinical conditions, or body weight. In addition, the home pressure measuring device that is opened to the patient is defined as "tool,". The operation of the tool is established on the home BP management page and is shown in the tenth b chart. The building tool of the tenth b diagram, according to the steps shown in the seventh & figure, implements the metrology meter after designing the first tracking visit (see Figure 7a). With the building tool, there is a clear serial number. The specific model of the device is defined. The dynamic blood pressure measurement cycle is defined for a specific number of working days. The specific measurement schedule is defined in the morning and the middle (at the work site) and during the night. By storing the data, as shown in Figure 10b, the data is stored in a database and can be transmitted to the home blood pressure measuring device via the Internet connection as shown in Figure 6. The face of the patient data during the diagnosis phase is displayed. The stage of diagnosis is defined as the initial, first, and second follow-up visits, as shown in Figure 7a. On the same page, the first page is displayed. Care station/clinic blood before the visit The measured knot made by the measuring device = the measurement made with the home blood pressure measuring device, and the measurement made by the ABPM simplification device between the first and second looking. The αβρμ is simplified and used for The average home blood pressure measurement device is exactly the same = setting. The morning/night function is a function of embedding the device. If the device is = calculated as ABP1V [simplified mode, the specified morning and evening can be performed ^ 23 200816952. The device's ABPM simplification function can be initiated or deactivated by the physician using software switching cries. Depending on the physician's choice, the ABPM simplification function can be initiated during any diagnostic, treatment, or tracking phase. && Whether the physician believes that the morning or evening measurement is appropriate, it can be activated to store laboratory tests, specific care plans (see also Figure 11), and specific drugs prescribed. At the end of the diagnostic phase: treatment. The browser interface is used to select stage moxibustion; the home blood pressure measuring device is changed to the treatment mode. The first = no significant > screen of the specific patient during the oral therapy mode. The picture is drawn on the screen by a graphic In addition, the sputum dry matter and blood pressure monitoring, the drug system for providing the type of drug for erecting is opened from, for example, the tool. The first year of May 20th. On May 5th, Kawaguchi In 2006, individual colors are displayed on the horizontal axis of the graph. By measuring the results of blood pressure measurement, different types of drugs are associated. In addition, during the treatment phase, the fine case can be obtained by super-chaining. Access the results of the second level of the test. Details - complete the treatment, #, more fine measurement results. Mode. The tenth e picture shows =, έ / A "堃 measurement device was changed to track the patient's web page “c shows the specific wake-up of the previous schema (for example, reminding the appointment to see the ^^ face. It can store several trials for the doctor to do specific tests, such as y waking up the case manager). These are used to insure the poor or remind the patient, for example, the mailbox of each person in the drug: in the second place = to the individual's compliance information in this system. Wu Wu, instructed about the blood pressure measurement 24 200816952 = s specific phase of the steps of the transplanting stage, the treatment stage, the tracking stage, the total implementation of the steps, the first visit to the patient, and the establishment of the patient's profile. Using the professional use of WatchBP, in the initial mode of diagnosis, measuring the 0ffice-BP in two arms, a designated laboratory test, a designated home WatchBP, and a physician. If the physician thinks it is necessary, measure it for one to three days with the "ABPM Simplification" function. Patients are also required to make night and work site measurements on the specified date. April 15th - First visit 1 - Use professional WatchBP to track the visit mode, in the arm with higher BP, measure Office-BP - upload Home WatchBP and ABPM Simplified Data - Review Laboratory Test Results - Diagnose according to guidelines - Open a drug - Establish a Care Plan 2 to give a patient a third visit on May 10, for example, via Internet Consultation - Upload a home at home WatchBp and ABPM simplify (if needed) information, and physicians review Home BP data and medication compliance information through WatchBP.NET. A physician decides to adjust the drug on May 1st - Physician Head or mail via the Internet to change the _ next to the patient known drug ^ 25200816952
5月20曰第 -使用專業用WatchBP，以追蹤就 四次就診 診模式，於具有較高BP之臂， 量測辦公室BP -上傳家用WatchBP及ABPM簡 化(如有需要)資料及服藥遵從性 結果於辦公室 -修改照護計劃於5月20曰 -若患者BP已受到控制，則醫師 完成藥物調整 -5月20曰後，患者於家中服用藥 物且做出量測/上傳BP 追蹤階段 5月20日後，患者進入追蹤階段且於家中服用藥 物且做出量測/上傳BP，而服務中心之照護管理者 可追衆患者的情況 例如··（1) 11月5日，醫師透過WatchBRnet檢視 患者的BP資料，並告知患者下一次看 診的時間。 (2) 6月6日，醫師告知患者進行另一種血 液測試。 (3) 7月30日，醫師可透過網際網路連接來 設定家用WatchBP及ABPM簡化，並 提醒患者在8月1日至8月19日以診 斷模式進行Home-BP。 (4) 8月1曰，醫師提醒患者在8月2曰以 ABPM簡化進行Home-BP。 (5) 照護管理者提醒患者透過網際網路連 接來上傳Home-BP及ABPM簡化資 料。 (6) 患者在7月20日告知藥師補充藥物。 ⑺患者在7月10曰諮詢藥師有關藥物相 關問題。 26 200816952 鏗於用於改變患者的生活方式之照護計劃，在治療 p白I又期間或之後可將特定教育材料指定給患者。指定材 料與顯示已被指定的材料之特定頁係顯示於第十f圖。 可連線下載這些資訊。 、’ 於診斷階段之第一次就診期間，建立患者概況。利 用專業用血壓量測裝置“專業用WatchBp”，於兩臂量測 血壓。可規定實驗室試驗。再者，可規定患者以“家用May 20th - use professional WatchBP to track the four-time consultation mode, with a higher BP arm, measurement office BP - upload home WatchBP and ABPM simplification (if needed) data and medication compliance results In the office - modify the care plan on May 20th - if the patient BP has been controlled, the doctor completes the drug adjustment - after 20 months, the patient takes the drug at home and makes a measurement / upload BP tracking phase after May 20 The patient enters the tracking phase and takes the drug at home and makes a measurement/upload BP, and the care center manager of the service center can track down the patient. For example, (1) On November 5, the physician examines the patient's BP through WatchBRnet. Information and inform the patient of the time of the next visit. (2) On June 6, the physician informed the patient to perform another blood test. (3) On July 30th, physicians can set up Home WatchBP and ABPM simplification via Internet connection and remind patients to conduct Home-BP in Diagnostic mode from August 1st to August 19th. (4) On August 1st, the physician reminded the patient to simplify Home-BP with ABPM on August 2nd. (5) The care manager reminds the patient to upload Home-BP and ABPM simplification materials via the Internet connection. (6) The patient told the pharmacist to replenish the drug on July 20. (7) The patient consulted the pharmacist about the drug related issue on July 10th. 26 200816952 A specific educational material can be assigned to a patient during or after treatment p white I, depending on the care plan used to change the patient's lifestyle. The specified material and the specific page showing the material that has been designated are shown in Figure 10f. You can download this information online. , Establish a patient profile during the first visit to the diagnosis phase. The blood pressure measuring device "Professional WatchBp" is used to measure blood pressure on both arms. Laboratory tests can be specified. Furthermore, the patient can be prescribed "home
WatchBP里測裝置做家中量測。若醫師認為合適，則該The WatchBP measuring device is used for home measurement. If the doctor thinks it is appropriate, then
豕用WjtchBP量測裝置亦可被設計成一、二、或三天 ABPM簡化量測。然後該患者將被要求做出夜間與工作 地點量測。 胃^第二次就診期間’由醫師於最初就診時具有較高 血壓頃數之臂，量測診所血壓。患者所取得之量測資料 係上傳至巾央資料庫。錢_驗室試驗絲後，可做 出特定診斷、可開立藥物、及可建立照護計割。此外， 可線上指定可選擇的教育材料給該患者。 之後’開始治療階段。第三次就診可線上做出，例 過網際網路諮詢。可從“家用WatchBp”或“ABpM簡 化裝置（若有規定）上傳家用量測血壓資料。昭護人員 =可透侧覽器介面（後文中稱為‘‘耐⑽”） 而可料及遷守服藥規^。可做出必要的藥物調整 藥物的改變透過系統中結合的電子郵件告知該患者 於第四次就職間，診所血壓再次 於具J較高初次▲壓讀數之臂上量測。^所里測衣置 家用取得的資料與遵守服藥規定 師的診所或至中央資料庫。可修改照護計 27 200816952 ，調^此會面之後’於家中服用進—步的藥物且做出 豕中量測。 士狄之後，開始追蹤階段。於服務中心（callcentre)之照 蔓笞理者可個別地追蹤患者。追縱可包含透過潮覽器介 面來檢閱患者的血壓資料。醫師亦可預約進一步的會 ，。醫師可通知患者進行進一步的實驗室試驗。醫師二 可在預定的時間週期，透過網際網路連接，建立家用裝 置的功能並提醒患者進行進一步的量測於診斷模式。^ ，L於上傳資料、再配藥物、或服藥遵從性，可與照 °蔓管理者或藥師進行通訊。 一第十一圖顯示對於特定患者的照護計劃。圖中係顯 示相關量測資料且係顯示對於該患者的特定計劃與開、 立的藥物。 ^第十二圖顯示一特定醫師對複數個患者所做的按 致果付費報告之範例。根據本發明之系統提供按效果付 費報告的產生。第十二圖顯示一特定醫師的報告，包含 對數個患者所做的量測結果。 可藉由選擇顯示於第十C圖至第十f圖的網頁之第 :行之合適的頁籤(tab)，選擇P4P報告、材料的指定、 信箱中的訊息、或患者相關資訊。 第十二圖顯示包含所有藥物及替代處方的個人藥 物紀錄。再者’係齡所有實驗該其他量測的概況。' 此個人藥物紀錄對於來自管理頁的醫師而言，可容易地 進行存取（見後文）。 第十四a圖至第十四j圖顯示藥物治療管理(mtm) 功能性的不同螢幕畫面。 第十四a圖顯示患者管理頁。照護人員（例如醫師或 28 200816952 藥，)對於列出的患者，可選擇藥物治療管 點擊各患者的MTM按鈕）。藉由 ’松杈式（错由 關所選擇的患者之進一步網F，=、#杈鈕，可開啟有 目，包含修改資料的日期、及該患者的複數個項 ⑴t %師或藥師對該患者實際 可修改特定患者的資料。）冑由坻擇編輯按鈕， 第十四e圖顯示編輯患者資料的 點擊顯示於第十四a_最末行之按钮，可The WjtchBP measuring device can also be designed to simplify the measurement of one, two or three days of ABPM. The patient will then be asked to make night and work location measurements. Stomach ^ During the second visit, the blood pressure of the clinic was measured by the physician with the arm of the higher blood pressure at the initial visit. The measurement data obtained by the patient is uploaded to the central bank database. After the money test, the test can be done to make a specific diagnosis, to open a drug, and to establish a care plan. In addition, optional educational materials can be assigned to the patient online. After that, the treatment phase begins. The third visit can be made online, including Internet consultation. You can upload home-measured blood pressure data from “Home WatchBp” or “ABpM Simplified Device (if specified). Zhaoshou staff = can pass through the browser interface (hereinafter referred to as ''resistant (10))) and can take medication Regulation ^. The necessary drug adjustments can be made. The drug changes are communicated to the patient via a combined email in the system. At the fourth inauguration, the clinic blood pressure is again measured on the arm with a higher initial ▲ pressure reading. ^ The surveyed clothing is used to obtain information from the home and to comply with the medication regulations of the division's clinic or to the central database. The caregiver can be modified 27 200816952, after the meeting, take the medicine in the home and take the measurement. After Shi Di, start the tracking phase. Photographs at the callcentre The vines can track patients individually. Tracking can include reviewing a patient's blood pressure data through a browser interface. The doctor can also reserve a further meeting. The physician can inform the patient for further laboratory testing. Physician 2 can establish the function of the home device through an internet connection within a predetermined time period and remind the patient to perform further measurements in the diagnostic mode. ^ , L can communicate with the manager or pharmacist when uploading data, re-doing drugs, or taking medication compliance. An eleventh figure shows a care plan for a particular patient. The figure shows the relevant measurement data and shows the specific plan and medication for the patient. ^Twelfth figure shows an example of a pay-as-you-go report made by a particular physician to a plurality of patients. The system in accordance with the present invention provides for the generation of payback reports. Figure 12 shows a report from a specific physician containing measurements made on several patients. The P4P report, the designation of the material, the message in the mailbox, or the patient related information can be selected by selecting the appropriate tab of the first line of the web page displayed in the tenth through tenth through tenth f maps. Figure 12 shows a personal drug record containing all medications and alternative prescriptions. Again, the results of this other measurement were tested for all ages. This personal drug record is easily accessible to physicians from the management page (see below). Figures 14a through 14th show different screen shots of medication management (mtm) functionality. Figure 14a shows the patient management page. Caregivers (eg physician or 28 200816952 drugs), for the listed patients, select the drug therapy tube Click on each patient's MTM button). By "slow-style" (the wrong network of patients selected by the off-line, =, # button, can open the target, including the date of modification of the data, and the patient's multiple items (1) t % division or pharmacist The patient can actually modify the data of the specific patient.) By selecting the Edit button, Figure 14e shows the button for editing the patient data displayed on the 14th a_last line button.
^料、藥師與主治醫師的姓名、特定類型的藥劑 草、補給品、有害反應（adVerSereacti〇n)、或副作用。 者，可輸入及閱覽實驗室與生物資料。 藉由點擊指向藥物的合適按叙，可利用_般目錄與 特定類型的藥物，來選擇特定藥物。再者，可利用每天 服用數量、劑量、服藥次數、或服藥天數來管理藥物。 可根據顯示於第十四C圖之預先定義的表來選擇有害反 應。再者，可輸入個別的有害反應。 σ 於第十四d圖的螢幕晝面中，可列出特定的反應並 歸屬於特定的照護人員。 藉由進一步向下捲拉（參見第十四g圖），可存取進 一步的資訊，例如金壓值或身體量測、相關問題、提出 的反應、接收的教育、反應的結果、及介入(intervention measure)/轉診。可藉由點擊合適按紐來輸入或修改相關 問題(參見第十四h圖）。同樣的，可藉由點擊合適按鈕 來輸入或修改提出的反應（參見第十四i圖）。一旦輸入 資料，則在整個網頁可直接看到該資料（參見第十四j 圖）。 藉由選擇第十四f圖中之列印按鈕，可產生第十三 29 200816952 圖所示的個人藥物紀錄。可根據需求選擇不同類型的報 告，例如PDF、純文字、或試算表檔案。The name of the pharmacist, the pharmacist and the attending physician, the specific type of herb, the supplement, the adverse reaction (adVerSereacti〇n), or side effects. You can enter and view labs and biometric materials. By clicking on the appropriate narration of the drug, you can use the _-like list and specific types of drugs to select a particular drug. Furthermore, the number of doses, doses, times of administration, or days of medication can be used to manage the medication. Harmful reactions can be selected based on a predefined table shown in Figure 14C. Furthermore, individual adverse reactions can be entered. σ In the screen of Figure 14d, specific reactions can be listed and attributed to specific caregivers. Further information can be accessed by further downward scrolling (see Figure 14g), such as gold pressure or body measurements, related issues, proposed responses, received education, response results, and interventions ( Intervention measure)/referral. You can enter or modify related questions by clicking the appropriate button (see Figure 14 h). Similarly, the proposed response can be entered or modified by clicking on the appropriate button (see Figure 14i). Once the data is entered, it can be seen directly throughout the web page (see Figure 14 j). By selecting the print button in Figure 14 f, the personal drug record shown in Figure 13 200816952 can be generated. Different types of reports can be selected as needed, such as PDF, plain text, or spreadsheet files.
30 200816952 【圖式簡單說明】 第一圖顯示根據本發明之系統的代表元立 第二圖顯示根據本發明之方法的步驟：程：意圖； 第三圖顯示根據本發明之系統的概要圖，·圃， 第四圖顯示根據本發明之系統的 通訊之方塊圖； J凡件與父互 第五圖顯示P4P報告的範例； 施例第六圖顯示家用血壓量測裝置之較佳替代具體實 第七a圖、第七_、第七。圖顯示用 一潛伏尚血壓之系統的操作流程圖； 、、九 第八圖顯示以根據本發明之系統用於高血 的系統化及綜合方式之概要圖； 第九圖顯示根據本發明之照護流程； 第十a圖至第十f圖顯示根據本發明之i统於網頁 式’丨面的操作之螢幕畫面； 、 第十一圖顯示根據本發明而產生之照護計劃的範 第十二圖顯示由一特定照護人員所產生的P4p報生 之範例； 视口 第十二圖顯示特定患者的個人藥物紀錄之具體每 知例；及 貝 第=四a圖至第十四』圖顯示於藥物治療管理中有 I患者藥物紀錄的網頁瀏覽器頁之螢幕晝面。. 1主要元件符號說明】 1糸統 ^ 豕用血壓量測裝置 31 200816952 15 服藥遵從性記錄器與提醒器 20 照護站量测系統 21 照護站血壓量測裝置 32 膝上型電腦 33 USB連接 34 網站資料庫伺服器 35 網站伺服器 40 資料庫30 200816952 [Simplified illustration of the drawings] The first figure shows a representative diagram of a system according to the invention. The second diagram shows the steps of the method according to the invention: the process: the intent; the third diagram shows a schematic diagram of the system according to the invention, · 圃, the fourth figure shows the block diagram of the communication according to the system of the present invention; the fifth figure of the parent and the parent shows the example of the P4P report; the sixth figure of the embodiment shows the better alternative of the home blood pressure measuring device Seventh a, seventh, seventh. The figure shows an operational flow chart of a system using a latent blood pressure; and, the eighth figure shows a schematic diagram of a systemized and integrated manner for high blood using the system according to the present invention; and the ninth figure shows the care according to the present invention. The tenth to tenth fth diagrams show a screen image of the operation of the webpage in accordance with the present invention; and the eleventh figure shows the twenty-first diagram of the care plan generated according to the present invention. An example of a P4p report generated by a particular caregiver; a twelfth view of the viewport showing the specific per-information of the individual's personal drug record; and a Betto = four a to fourteenth figure showing the drug In the treatment management, there is a screen page of the web browser page of the patient record of the patient I. 1 Main component symbol description 1 糸 ^ 血压 血压 blood pressure measuring device 31 200816952 15 medication compliance recorder and reminder 20 nursing station measuring system 21 nursing station blood pressure measuring device 32 laptop 33 USB connection 34 Website Database Server 35 Website Server 40 Database
3232
Claims (1)
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| EP06100653A EP1810612A1 (en) | 2006-01-20 | 2006-01-20 | A system and method for hypertension management |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| TW200816952A true TW200816952A (en) | 2008-04-16 |
| TWI328439B TWI328439B (en) | 2010-08-11 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| TW096102196A TWI328439B (en) | 2006-01-20 | 2007-01-19 | A system and method for hypertension management |
Country Status (4)
| Country | Link |
|---|---|
| US (1) | US20100280395A1 (en) |
| EP (1) | EP1810612A1 (en) |
| TW (1) | TWI328439B (en) |
| WO (1) | WO2007082930A1 (en) |
Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10089443B2 (en) | 2012-05-15 | 2018-10-02 | Baxter International Inc. | Home medical device systems and methods for therapy prescription and tracking, servicing and inventory |
| WO2010017190A1 (en) | 2008-08-04 | 2010-02-11 | Laboratory Corporation Of America Holdings | Clinical laboratory-based disease management program, with automated patient-specific treatment advice |
| US9220440B2 (en) * | 2009-09-21 | 2015-12-29 | Nellcor Puritan Bennett Ireland | Determining a characteristic respiration rate |
| WO2011110491A1 (en) * | 2010-03-09 | 2011-09-15 | Sabirmedical, S.L. | A non-invasive system and method for diagnosing and eliminating white coat hypertention and white coat effect in a patient |
| WO2013036776A2 (en) * | 2011-09-09 | 2013-03-14 | Welch Allyn, Inc. | Blood pressure monitoring system and method |
| JP6861481B2 (en) | 2016-07-06 | 2021-04-21 | オムロンヘルスケア株式会社 | Risk analysis system and risk analysis method |
| JP7354792B2 (en) * | 2019-11-26 | 2023-10-03 | オムロンヘルスケア株式会社 | Blood pressure monitor, blood pressure measurement method, and program |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0322711B1 (en) * | 1987-12-29 | 1994-07-27 | Kontron Instruments Holding N.V. | Blood pressure measuring device |
| US6918879B2 (en) * | 2000-10-09 | 2005-07-19 | Healthstats International Pte. Ltd. | Method and device for monitoring blood pressure |
| US20020087054A1 (en) * | 2001-01-03 | 2002-07-04 | Wen-Guai Lin | System and a method for monitoring the effectiveness of a medical treatment |
| US7074183B2 (en) * | 2001-06-05 | 2006-07-11 | Alexander F. Castellanos | Method and system for improving vascular systems in humans using biofeedback and network data communication |
| US20040059599A1 (en) * | 2002-09-25 | 2004-03-25 | Mcivor Michael E. | Patient management system |
| JP2004181137A (en) * | 2002-12-06 | 2004-07-02 | Omron Healthcare Co Ltd | Medicine storage case, medicine storage case with blood pressure measuring function, dosage management system, and hemodynamometer |
| WO2004104964A1 (en) * | 2003-05-14 | 2004-12-02 | Jms Co., Ltd. | Device for transmitting data via the internet |
| US20040249250A1 (en) * | 2003-06-04 | 2004-12-09 | Mcgee Michael D. | System and apparatus for monitoring and prompting medical self-care events and communicating medical self-care status |
| CA2602899A1 (en) * | 2005-03-21 | 2006-09-28 | Software Solutions Limited | System for continuous blood pressure monitoring |
| DK1893082T3 (en) * | 2005-06-14 | 2011-01-03 | Microlife Intellectual Prop | Blood pressure monitor and device for operating a blood pressure monitor |
-
2006
- 2006-01-20 EP EP06100653A patent/EP1810612A1/en not_active Withdrawn
-
2007
- 2007-01-19 WO PCT/EP2007/050533 patent/WO2007082930A1/en not_active Ceased
- 2007-01-19 TW TW096102196A patent/TWI328439B/en not_active IP Right Cessation
- 2007-01-19 US US12/161,406 patent/US20100280395A1/en not_active Abandoned
Also Published As
| Publication number | Publication date |
|---|---|
| US20100280395A1 (en) | 2010-11-04 |
| EP1810612A1 (en) | 2007-07-25 |
| TWI328439B (en) | 2010-08-11 |
| WO2007082930A1 (en) | 2007-07-26 |
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